Individual provider Active NPI

Debra L. Lanouette, CRNP-PMH

  • Psychiatric/Mental Health Nurse Practitioner
  • Ellicott City, MD
National Provider Identifier
1831458306
Registry record updated Oct 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R057335 Issued in MD
Practice address
12920 Triadelphia Rd
Ellicott City, MD 21042-1122
Phone
(410) 979-3610
NPI assigned
May 3, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R057335 MD Primary

Addresses

Primary practice location

12920 Triadelphia Rd
Ellicott City, MD 21042-1122

Mailing address

12920 Triadelphia Rd
Ellicott City, MD 21042-1122
Phone (410) 979-3610

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120727000458 MD Practitioner - Nurse Practitioner 9638335110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Debra Lanouette CRNP-PMH LLC Psychiatric/Mental Health CurrentSince Sep 16, 2021 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

314 W Patrick St
Frederick, MD 21701
Phone (301) 471-9504

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1336003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634688000000",
    "number": "1831458306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12920 TRIADELPHIA RD",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210421122",
            "telephone_number": "410-979-3610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12920 TRIADELPHIA RD",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210421122",
            "telephone_number": "410-979-3610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANOUETTE",
        "first_name": "DEBRA",
        "middle_name": "L.",
        "credential": "CRNP-PMH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-03",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R057335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

Verify at the official NPI Registry.